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Updated: Apr 9, 2026
Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
Published on: September 18, 2012
Evaluating three methods to encourage mentally competent older adults to assess their driving behavior
Tarsicio Uribe-Leitz1, Lisa Allee Barmak, Angela Park
1From the Boston University School of Public Health (T.U.-L., A.P., E.L., C.D.), and Departments of Surgery (L.A.B., P.A.B., T.D.), and Emergency Medicine (J.H.), Boston University School of Medicine (V.L.), Boston Medical Center, Boston, Massachusetts; and Department of Surgery (T.U.-L.), Stanford University, Stanford, California.
Background:
Fourteen percent (43.1 million) of the population in the United States was 65 years and older in 2012. This population is projected to reach 20% (88.5 million) by 2050. Older adults accounted for 17% of all traffic fatalities and 9% of all vehicle occupant injuries in 2012. We explored the effectiveness of three interventions to help older adults assess their current driving behaviors at a Level 1 trauma center.
Methods:
During 2010 to 2012, 1,216 inpatients 70 years and older admitted for surgical and medical services were screened for eligibility, and 120 were enrolled. Participants completed a driving assessment and preintervention questionnaires and were subsequently randomized to one of the following interventions: (1) brief negotiated interview plus an educational kit by the American Automobile Association about older driving plus an accompanying list of Web-based resources for older adult drivers; (2) American Automobile Association document and a list of Web-based resources; (3) online referral sheet of the list of Web-based resources only. A 3-month postintervention follow-up questionnaire was administered over the telephone to measure changes in (1) driving-related knowledge, attitudes, and beliefs as well as (2) driving-related behaviors and intended behaviors.
Results:
A total of 113 randomized patients were included in the analysis. The mean (SD) age was 76.8 (5.23) years; majority of patients were white (64%), followed by black African American (33%); and 51% were males and 49% were females. Multivariate analysis showed that older adults' driving knowledge, attitudes, and beliefs (p < 0.0001, R = 0.37) as well as behaviors and intentions (p < 0.0001, R = 0.27) toward driving were positively correlated, controlling for other predictors in the model. Intervention assignment did not affect changes in outcomes, although outcomes improved across experimental conditions.
Conclusion:
Our pilot study suggests that older adults are likely to make changes in their driving behavior on the basis of minimal hospital-based intervention.
